Directly Speaking - The Other Side of Addictions

by Scott A. Meyers, Executive Vice President
February 13, 2015

The UIC Student Chapter of ICHP is working on putting a panel together to talk about addiction and substance abuse in pharmacy and health care. It is a laudable undertaking and a topic that many pharmacy directors and managers have to deal with, often more than once in their careers.

It’s been 16 years since I have worked in a hospital pharmacy but in my 22+ years in the trenches, I have worked with more than a half dozen pharmacists who we eventually found were impaired pharmacists and whose addictions cost them as little as a reprimand to as much as their lives! I have had several other pharmacist friends who I knew but didn’t work with whose careers and in one case whose life were impacted in the same way.

Substance abuse and the addiction that can follow are common in all walks of life and are no more rare in health care than anywhere else.¹ Every third Friday night after I close the door at ICHP, I go to my part-time job (for no pay) as a security guard at our Church’s Celebrate Recovery (CR). As a volunteer, it’s my responsibility to make sure the Church and the people who attend this weekly event stay safe. Whether it is to monitor the behavior of an attendee who appears to be under the influence, provide first aid and call for an ambulance in a medical emergency or insure that the kids who are present at Celebration Station (program for 5 year olds to 5th graders) go home with the right parents. But at these Friday evening meetings, I also get to meet and hear stories from some of the nicest people and at one time, biggest drug addicts or alcoholics you can imagine. I can thankfully say many of these people are now my friends and they have taught me a lot about the other side of addictions.

I’ve learned a lot from these friends and their stories and perhaps the most important is that no one ever plans to become an addict or alcoholic! It’s not a life goal on their bucket list. Few see the process taking place until it is often way too far along. But of those who have come through the addiction and are in recovery, you find amazingly kind and giving people. They are people who continue to give back to the community they live in and often times the professions they came from.

If you are a veteran pharmacist, you’ve probably seen a few drug and alcohol issues with fellow employees. If you are a new graduate, hopefully you haven’t run into this yet, but surely you will. If you did or when you do it might happen like this: You work with someone who smells of alcohol at the beginning of a shift one day and it takes you by surprise the first time it happens. But then every time you work with them after that you’re quick to sniff to see if they need to have their work double checked or more importantly an intervention with the hospital’s Employee Assistance Program (EAP). It’s harder to spot the drug user because there’s no telltale smell to give them away, but sooner or later their impairment becomes significant enough that you know there’s something wrong and they need help too. They move more slowly or have trouble concentrating. They don’t finish one task before starting another.

Impaired pharmacy employees create significant strain on the rest of the department staff. Some of the staff feel they need to follow the impaired individual around and double check everything they do. Other less sympathetic employees will complain to each other that the impaired employee isn’t carrying their share of the workload. And many pharmacy employees are afraid to confront the impaired employee or even report them to the pharmacy administration because they don’t want to cause problems. The problem is that an impaired pharmacy employee is a safety problem that should be dealt with quickly and fairly.

The Illinois Pharmacy Practice Act provides funding to assist an impaired pharmacist or technician who has found that they have developed an addiction to alcohol or drugs. Participation in the program, the Illinois Professionals Health Program, can be initiated by the impaired pharmacist or technician, by their employer or by the state. If the impaired individual enters the program on their own and before any intervention by their employer or the state, the process can remain confidential, as long as the individual professional follows the requirements of the program. And some of the requirements will incur costs to the individual for drug and alcohol screens and other incidental items. The program is not completely free. If the employer intervenes before there is a need to report to the state (reporting is required when significant diversion occurs or a patient is harmed), the process can remain confidential also, and the employer may even be willing to pay for any costs incurred. In many cases, though, the state mandates participation, the individual often loses his/her job and his/her license is suspended or revoked. Successful completion of the program may provide the impaired individual with the opportunity to regain their license, but the costs are the highest both financially and psychologically.

Some of the pharmacists and technicians I’ve known have gone through the recovery program and are back at their jobs doing better than ever. There are three or four who lost their lives to conditions that could have been successfully treated. And there are a few who just walked away from pharmacy. The work of recovery was either too hard or the price was too high. Unfortunately, it was that way only in their minds. Addictions do not have to be career-ending, and I hope to never hear of another one being life-ending, but I know that will not be the case. We need to be aware of the warning signs of addiction, know where to turn when one is identified and be willing to reintegrate those professionals who have bravely worked their recovery and earned their way back into the profession. We need to encourage those individuals to share their stories with all professionals so that we all can learn from their mistakes and from the other side of addictions.

Celebrate Recovery (CR) is a faith-based recovery program that follows the twelve steps of Alcoholics Anonymous (AA).  Narcotics Anonymous (NA) follows a similar 12-Step program. Here are the 12 Steps of AA²:
  1. “We admitted we were powerless over alcohol – that our lives had become unmanageable.”
  2. “Came to believe that a Power greater than ourselves could restore us to sanity.”
  3. “Made a decision to turn our will and our lives over to the care of God as we understood Him.”
  4. “Made a searching and fearless moral inventory of ourselves.”
  5. “Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.”
  6. “Were entirely ready to have God remove all these defects of character.”
  7. “Humbly asked him to remove our shortcomings.”
  8. “Made a list of all persons we had harmed, and became willing to make amends to them all”.
  9. “Made direct amends to such people wherever possible, except when to do so would injure them or others.”
  10. “Continued to take personal inventory and when we were wrong promptly admitted it.
  11. “Sought through prayer and meditation to improve our conscious contact with Godas we understood Him, praying only for knowledge of His will for us and the power to carry that out.”
  12. “Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.”

¹ U.S. Department of Justice, Drug Enforcement Administration.  Drug Addiction in Health Care Professionals. (accessed 2015 Jan 27).
² Alcoholics Anonymous. Twelve Steps and Twelve
 (accessed 2015 Jan 27).

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